Predictive Factors Of Disability Research Articles

Disability Among Older Adults Residing in Poldasht, Iran in 2018: The Role of Social Aupport as A Protective Factor

Objectives: The present study examined the role of social support in protecting against disability among older people residing in Poldasht, West Azerbaijan Province, Iran in 2018. Methods: This cross-sectional study was undertaken on 305 older adults who were selected by random sampling method. The World Health Organization standardized disability scale (WHODASS2) and multidimensional scale of perceived social support (MSPSS) were applied to collect the data. Data analysis was run through a multiple linear regression model by SPSS software, version 23. The significance level was set at P≤0.05. Results: The mean age of older people was 69.13±7.63 years. The highest incidence of disability was in the subscale of community participation (n=111, 36.4%) and mobility (n=111, 36.4%). The results revealed that age (β=0.32, P<0.001), financial status (β=0.14, P=0.002), job (β=-0.18, P=0.02), number of physical illnesses (β=-0.21, P<0.001), and social support (β=-0.17, P<0.001) were predictive factors of disability among older people. Discussion: The results showed a high prevalence of disability among older people. Given the protective role of social support in reducing disability, it is suggested to consider this cost-effective factor in attempts to deal with disability and then promote the quality of life of this vulnerable group.

P148 Work Ability Index (WAI) as a suitable instrument to assess work ability among IBD patients

Abstract Background Inflammatory bowel disease(IBD) is a chronic disease usually diagnosed in early adulthood and characterized by unpredictable flare-ups and debilitating symptoms that can interfere with the patient's ability to work and perform daily activities. In fact, since work disability is difficult to quantify, several scores have been developed for this purpose. The Work Ability Index(WAI) is a validated practical tool to measure the work capacity of patients. The objective of this study was to assess work performance in patients followed for IBD using the WAI psychometric tool, and to identify predictive factors of work disability. Methods We conducted a cross-sectional study including working patients followed for IBD, over a 9-months period. We collected sociodemographic, clinico-biological and evolutionary data. Quality of life was assessed by the IBDQ questionnairy. Work capacity was assessed using the WAI, a short 7-item questionnairy, which classified work performance into four categories: poor (score between 7-27), moderate(28-36), good(37-43) and excellent(44-49). Results We included 45 patients: 80% Crohn disease and 20% ulcerative colitis. The mean age was 44 years[20-72], the sex-ratio M/F was 0.7, and the mean of follow-up time was 9 years[1-18]. The average number of working hours per week was 38.84 [9-60]. The mean absenteeism during the last twelve months was 49.6 days [0-240] and the average number of hospitalization days was 30.7 [0-150]. The mean WAI value was 32.58, which corresponds to a moderate work performance. Assessment of work performance according to the WAI questionnaire showed that 38% of patients (N=17) had poor work ability, 24% (N=11) moderate work ability, 33% (N=15) good work ability and only two patients had an excellent work ability. In univariate and multivariate study, predictive factors of disability at work in IBD patients were: Furthermore, the assessment of health-related quality of life by the IBDQ questionnairy showed a mean IBDQ value of 160.78 which corresponds to a moderate score relating a quality of life; 224 being the maximum score obtainable reflecting an optimal quality of life. In the analytical study and using Spearman's test, a statistically significant correlation was found between the WAI and IBDQ with a p-value <0.0001 and a correlation coefficient r=0.7, reflecting the impact of work life on quality of life. Conclusion In our study, one third of patients had poor work capacity. Risk factors for poor performance were disease severity, presence of osteoarticular extraintestinal manifestation, and patients with children. The only protective factor identified was a high level of education. Thus, the Work Ability Index can be used as a screening tool to identify the need for rehabilitation.

Spinal cord involvement by atrophy and associations with disability are different between multiple sclerosis and neuromyelitis optica spectrum disorder.

The cervical and thoracic cross-sectional spinal cord area (CS-SCA) in multiple sclerosis (MS) correlates with disability, whilst such a correlation remains to be established in neuromyelitis optica spectrum disorder (NMOSD). Our aim was to clarify differences between MS and NMOSD in spinal cord segments where CS-SCA is associated with disability. The CS-SCA at C2/C3, C3/C4, T8/T9 and T9/T10 vertebral disc levels was measured in 140 MS patients (111 with relapsing-remitting MS and 29 with progressive MS) and 42 NMOSD patients with anti-aquaporin-4 immunoglobulin G. Disability was evaluated by Expanded Disability Status Scale (EDSS) scores. Multivariate associations between CS-SCA and disability were assessed by stepwise forward multiple linear regression. Thoracic CS-SCA was significantly smaller in NMOSD patients than in MS patients even after adjusting for age, sex and disease duration (P=0.002 at T8/T9), whilst there was no difference in cervical CS-SCA between the two diseases. Cervical and thoracic CS-SCA had a negative correlation with EDSS scores in MS patients (P<0.0001 at C3/C4 and P=0.0002 at T8/T9) whereas only thoracic CS-SCA correlated with EDSS scores in NMOSD patients (P=0.0006 at T8/T9). By multiple regression analyses, predictive factors for disability in MS were smaller cervical CS-SCA, progressive course, older age and a higher number of relapses, whilst those in NMOSD were smaller thoracic CS-SCA and older age. Thoracic CS-SCA is a useful predictive marker for disability in patients with NMOSD whilst cervical CS-SCA is associated with disability in patients with MS.

Predictive Factors for Disability in Patients with Acute and Chronic Headache

Background: Headache is one of the most common types of pain which is considered among the most disabling of diseases. However, the severity of disability in some headache patients is more than others. Objectives: The aim of the present study was to compare different types of headache regarding pain-related variables and psychological factors. We also examined the predicting factors of disability in patients with headache. Methods: This cross-sectional study was performed in 320 patients with various types of headache based on the International Headache Society criteria, which was assessed by neurologists. Data was collected using migraine disability assessment for disability, frequency of headache and for pain intensity, patient health questionnaire for depression, and pain anxiety symptoms scale for pain-related anxiety. ANOVAs and post hoc Tukey’s tests were used for comparing various types of headaches regarding pain-related and psychological factors. Regression analyses assessed the relation of pain-related and psychological variables with disability. Results: Patients with different types of headache revealed no significant differences regarding pain intensity (P = 0.27). Migraine patients showed the most pain frequency and chronicity compared to the other patients (P = 0.000). The levels of disability (P = 0.000), anxiety (P = 0.000) and depressive symptoms (P = 0.000) were also higher in patients with migraine compared to patients suffering from cluster or tension type headache. Pain chronicity (P = 0.01), anxiety (P = 0.007) and depression (P = 0.002) made significant contributions to the explanation of variance in ‘disability’. Conclusions: The findings add further evidence to the relevance of cognitive-behavioral models of pain suggesting an important role for pain-related emotions regarding the consequences of pain (e.g. disability). The current data could help clinicians to decide which factors should be considered for a successful treatment of disability in headache patients.

Functional Limitations and Disability in Persons Living with HIV in South Africa and United States: Similarities and Differences

Persons living with HIV (PLHIV) may experience disability. We compared disability among PLHIV in the United States and South Africa and investigated associations with health and demographic characteristics. Secondary analysis of cross-sectional data using medical records and questionnaires including the World Health Organization Disability Assessment Schedule (WHO-DAS) 2.0 12-item version (range: 0-36, with higher scores indicative of more severe disability). Between-country differences for the presence of disability were assessed with logistic regression and differences in severity using multiple regression. Eighty-six percent of US participants reported disability, compared to 51.3% in South Africa. The mean WHO-DAS score was higher in the United States (12.09 ± 6.96) compared to South Africa (8.3 ± 6.27). Participants with muscle pain, depression, or more years since HIV diagnosis were more likely to report disability. Being female or depressed was associated with more severity. Being adherent to anti-retroviral therapy (ART) and employed were associated with less severity. Because muscle pain and depression were predictive factors for disability, treatment of those problems may help mitigate disability in PLHIV.

PREDICTORS OF DISABILITY IN PRETERM INFANTS DURING EARLY CHILDHOOD

There is impossible to give clear recommendations on the trajectory of the further development of a premature baby for a practical doctor. Despite the rich accumulated experience of the risks of developmental disorders in premature infants, the search for its predictors is continuing. The aim was to assess the developmental evaluation of preterm infants during early childhood and predict of disability. Materials and methods. The data of 172 children were processed. Perinatal period, electroencephalographic patterns and developmental assessment by KID-RCDI-2000 was performed. Multivariate statistical logisticregression analysis was used to determine the predictors of disability in young children. Results. Predictive factors of disability (from 38 clinical and instrumental characteristics) were following: bronchopulmonary dysplasia,electroencephalographic’s patterns as delta- and teta-rhythm, and developmental delay by developmental scale till 12 month corrected age. Conclusion. The tool for predicting the development delay and disability in children born prematurely was established by multiple logistic regressions. The basis predictors are clinical, instrumental (standard EEG), and developmental scale results. This allows of a practicing doctor to focus on the development ofthe child and to apply of children with developmental delays to early intervention or rehabilitative services.

Onset to hospital admission time and disability in patients with ischemic stroke

The predictive factors of disability in stroke patients are still varied and subject to debate. Lower onset to admission time has been known produces excellent outcomes with significantly lower rates of morbidity and mortality. Previous study about the onset admission time in patients with stroke ischemic in Indonesia is very limited. This was a retrospective cohort study using secondary data from electronic medical record and electronic stroke registry of Bethesda Hospital Yogyakarta Indonesia. A total of 1657 patients with ischemic stroke was admitted between 2015-2017 and 313 patients were included in this study adjusted by inclusion and exclusion criteria. Factors such as age, gender, onset, previous stroke, comorbidities and complications were assessed. Multiple logistic regression analysis showed onset > 6 hour (RR: 4.567; 95% CI: 2.372-8.792;p: 0.000), age (RR: 2.366; 95% CI: 1.357-4.125;p:0.002) and patients with complications (RR: 12.403; 95% CI:2.443-62.968;p:0.002) were independently significant increasing the risk of disability in patient with ischemic stroke. Onset to hospital admission time > 6 hour was significantly increasing disability on ischemic stroke patients. Giving treatment less than 6 hours could save the patient from disability.

Complications as important predictors of disability in ischemic stroke

BackgroundStroke is the main cause of disability and death in many countries. The high incidence of disability in stroke survivors requires special attention to determine various predictive factors of disability. This study aimed to identify the various predictive factors of disability in ischemic stroke.MethodsThis study was a cross sectional study on 4510 ischemic stroke patients. Each patient’s data had been recorded in the electronic stroke registry of Bethesda Hospital. Ischemic stroke diagnosis was confirmed by brain CT scan, which was interpreted by a neurologist and a radiologist. Disability was assessed using the modified Rankin scale. Predictors of disability were assessed. Multiple logistic regression analysis was used to analyse the data. ResultsThe subjects were predominantly males, &gt;60 years of age, and suffered stroke for the first time. The incidence of disability was 31.5% (1420/4510). Multiple logistic regression analysis showed that the presence of complications (OR: 6.43; 95% CI: 4.74-8.73; p&lt;0.001), decreased level of consciousness (OR: 4.82; 95% CI: 3.95-5.90; p &lt;0.001), onset ³3 hours (OR: 1.93; 95% CI: 1.52-2.45; p&lt;0.001), recurrent stroke (OR: 1.63; 95% CI: 1.39-1.90; p&lt;0.001), and age &gt;60 years (OR: 1.55; 95% CI: 1.35-1.79; p&lt;0.001) were independent predictive factors of disability.ConclusionWe demonstrated that a substantial proportion of patients with ischemic stroke become disabled. And the presence of complications was the most predictive factor of disability in ischemic stroke.

Can epidemiological factors affect the 2-year outcomes after surgery for degenerative lumbar disease in terms of quality of life, disability and post-surgical pain?

PurposeTo evaluate the influence of epidemiological factors on the outcomes of surgery for degenerative lumbar disease in terms of quality of life, disability and chronic pain. Material and methodA total of 263 patients who received surgery for degenerative lumbar disease (2005–2008) were included in the study. The epidemiological data collected were age, gender, employment status, and co-morbidity. The SF-36, Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI), and VAS score for lumbar and sciatic pain were measure before and 2 years after surgery. The correlation between epidemiological data and questionnaire results, as well as any independent prognostic factors, were assessed in the data analysis. ResultsThe mean age of the patients was 54.0 years (22–86), and 131 were female (49.8%). There were 42 (16%) lost to follow-up. Statistically significant correlations (P<.05) were observed between age, gender, co-morbidity, permanent sick leave, and pre-operative pain with changes in the ODI, COMI, physical and SF-36 mental scales, and lumbar and sciatic VAS. Linear regression analysis showed permanent sick leave and age as predictive factors of disability (β=14.146; 95% CI: 9.09–29.58; P<.01 and β=0.334; 95% CI: 0.40–0.98, P<.05, respectively), and change in quality of life (β=−8.568; 95% CI: −14.88 to −2.26; P<.01 and β=−0.228, 95% CI: −0.40 to −0.06, P<.05, respectively). ConclusionBased on our findings, age and permanent sick leave have to be considered as negative epidemiologic predictive factors of the outcome of degenerative lumbar disease surgery.

¿Pueden influir las variables epidemiológicas el resultado a los 2 años de una cirugía por enfermedad lumbar degenerativa en términos de calidad de vida, discapacidad y dolor postoperatorio?

PurposeTo evaluate the influence of epidemiological factors on the outcomes of surgery for degenerative lumbar disease in terms of quality of life, disability and chronic pain. Material and methodA total of 263 patients who received surgery for degenerative lumbar disease (2005-2008) were included in the study. The epidemiological data collected were age, gender, employment status, and co-morbidity. The SF-36, Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI), and VAS score for lumbar and sciatic pain were measure before and 2 years after surgery. The correlation between epidemiological data and questionnaire results, as well as any independent prognostic factors, were assessed in the data analysis. ResultsThe mean age of the patients was 54.0 years (22-86), and 131 were female (49.8%). There were 42 (16%) lost to follow-up. Statistically significant correlations (P<.05) were observed between age, gender, co-morbidity, permanent sick leave, and pre-operative pain with changes in the ODI, COMI, physical and SF-36 mental scales, and lumbar and sciatic VAS. Linear regression analysis showed permanent sick leave and age as predictive factors of disability (β=14.146; 95% CI: 9.09 – 29.58; P<.01 and β=0.334; 95% CI: 0.40 – 0.98, P<.05, respectively), and change in quality of life (β=−8.568; 95% CI: -14.88 – −2.26; p<.01 and β=−0.228, IC95% CI: −0.40 – −0.06, P<.05, respectively). ConclusionBased on our findings, age and permanent sick leave have to be considered as negative epidemiologic predictive factors of the outcome of degenerative lumbar disease surgery.

Retraso en el diagnóstico de lepra como factor pronóstico de discapacidad en una cohorte de pacientes en Colombia, 2000 - 2010

Evaluate predictive factors of disability at time of leprosy diagnosis in a cohort of Colombian patients, from 2000 to 2010. Descriptive and analytical observational study of a retrospective cohort of patients admitted with a leprosy diagnosis to the Centro Dermatológico Federico Lleras Acosta in Bogotá, Colombia, from 2000 to 2010. Variables were analyzed descriptively and predictive factors for disability at diagnosis were identified through simple and multifactorial analyses (Cox proportional hazards model); hazard ratios for each factor in the model were calculated. Time between first symptoms and diagnosis in the 333 cohort patients was 2.9 years on average; 32.3% had certain degree of disability, especially for the feet. Delay in diagnosis and disability was greater in men than in women and in patients with multibacillary rather than paucibacillary leprosy. Disability was significantly associated with delays of ≥ 1 year in diagnosis, age ≥ 30 years, initial bacillary index of ≥ 2, multibacillary leprosy, and natives of the Cundinamarca or Santander departments. Protective factors were female sex, having some education, and residence in Boyacá. Time between first symptoms and diagnosis is the key predictive factor of disability at time of leprosy diagnosis. Strengthening of active searching for infected people and promotion of early diagnosis are recommended.

Predictive Factors for Disability as Evaluated by the Health Assessment Questionnaire in Rheumatoid Arthritis: A Literature Review

Functional disability in rheumatoid arthritis (RA) reflects the cumulative effects of the disease over time and is an important outcome measure. Various factors are responsible for functional disability, such as pain, swollen joints, joint tenderness and damage, deformities but also fatigue and depression. The most commonly used instrument for evaluating functional disability in RA is the health assessment questionnaire (HAQ), a self reported questionnaire. Numerous longitudinal studies have attempted to identify predictors of disability in RA and their results show that the most common variables associated with future disability are baseline HAQ or its variation during the first year of follow-up, female sex and old age. The HAQ score is a valuable indicator of disability in RA and has been shown to be predictive of loss of employment and mortality in RA. It may therefore be regarded as a relevant outcome variable in clinical trials and for the management of patients with RA in clinical practice.

Predictive factors of social disability in patients with eating disorders.

The study was designed to assess whether social avoidance symptoms and/or comorbid anxiety disorders were predictive factors of social disability in subjects with eating disorders. Sixty-three subjects with anorexia nervosa or bulimia nervosa were assessed for lifetime diagnoses of anxiety disorders, childhood history of separation anxiety disorder, social avoidance symptoms and social disability. On the Groningen Social Disabilities Schedule, 86% of the anorexics and 65% of the bulimics had disability regarding the 'social role', and 86% and 61 % disability regarding the 'occupational role'. Using all subsets logistic regression analyses, predictive factors of disability were: (1) for the social role, social avoidance symptom score (p<0.002) and diagnosis of separation anxiety disorder (p<0.01); (2) for the occupational role, number of lifetime anxiety disorders (p<0.01) and diagnosis of separation anxiety disorder (p<0.06). Recognizing and treating comorbid anxiety disorders in subjects with eating disorders could improve social adaptation and global psychopathological outcome.

Long-term prognosis of symptomatic lacunar infarcts. A hospital-based study.

This study concerns the long-term prognosis of lacunar infarcts. We report the analysis of our hospital-based series of 178 patients consecutively admitted for a lacunar syndrome due to a lacunar infarct diagnosed with computed tomography and magnetic resonance imaging. Demographic data, medical history, vascular risk factors, and imaging data were recorded for each patient. The follow-up was 35 +/- 22 months. The lacunar syndrome was pure motor hemiparesis in 69 patients (39%), ataxic hemiparesis in 45 patients (25.4%), pure sensory stroke in 15 patients (8.5%), sensorimotor stroke in 14 patients (7.9%), and miscellaneous syndrome in 34 patients (19.2%). The 4-year survival rate was 80 +/- 4% and the 4-year survival rate without recurrent stroke was 85 +/- 3.5%. Using Cox proportional-hazards analysis, the predictors of death were age (P < .02), diabetes mellitus (P < .05), and cigarette smoking (P < .05). We did not find any predictors of recurrence. After 1 year, 74% of the patients had mild or no disability. Using logistic regression analysis, the predictive factors of disability were age more than 70 years (P < .01), diabetes (P < .01), history of stroke or transient ischemic attack (P < .05), and type of lacunar syndrome (P < .01). Imaging data, number of lacunes, and presence of leukoaraiosis were not predictors of outcome. Our study suggests that with a high survival rate, a low recurrence rate, and a relatively good functional recovery, lacunar infarcts have a relatively favorable prognosis.